Abdominal Aortic Aneurysm

Question 1

90% of AAA can be found where?

Answer 1

Just below where the renal arteries split off of the abdominal aorta above the aortic bifurcation

Question 2

What causes aneurysms?

Answer 2

Weakened vessel walls e.g. through atherosclerosis or vasa vasorum hyaline arteriosclerosis

Question 3

What are the vasa vasorum

Answer 3

The tiny network of blood vessels that supply the muscular layers of the aorta

In hypertension, hyaline arteriosclerosis may occur which causes narrowing of vasa vasorum walls

Question 4

What are the RFs for AAA

Answer 4

Male, >60, hypertension, smoking, tertiary syphilis

Syphilis causes inflammation of tunica intima of vasa vasorum

Also Marfans, Ehlers-Danlos syndrom contribute to aneurysm

Question 5

Thoracic aneurysms which cause aortic insufficiency (by pulling on aortic valve) has which sign?

Answer 5

High pitched brassy cough - because left recurrent laryngeal nerve is stretched

Question 6

What are the classical signs of abdominal aortic aneurysm

But they can also be asymptomatic

Answer 6

1. Severe left flank pain - extends to abdomen, chest, lower back, groin
2. Pulsating mass with heartbeat
3. Hypotension

Question 7

How are AAAs treated

Answer 7

If they are judged to be risky enough to the patient, can be treated surgically